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CITY OF ORONO PERMIT NO.: 2009-00724 <br /> � 2750 KELLEY PARKWAY <br /> � ORONO, MN 55356- DATE issUEn: 10/19/2009 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 2715 COUNTRYSIDE DR W <br /> PIN : 04-117-23-12-0019 <br /> LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN <br /> : LOT 004 BLOCK 003 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUATION : $ 2,156.00 <br /> NOTE: 1 GARAGE HEATER-NATURAL GAS <br /> APPLICANT MECHANICAL 50.00 <br /> HEATING & COOLING TWO INC. STATE SURCHARGE MECH (VALUATION) 1.08 <br /> 18550 COUNTY ROAD 81 TOTAL 51.08 <br /> MAPLE GROVE,MN 55369- <br /> (763)428-3677 <br /> OWNER <br /> WILSON, MARK& KIRSTIN <br /> 2715 COUNTRYSIDE DR W <br /> LONG LAKE, MN 55356- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed accordine to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of Ihe date of issuance,or if construction is <br /> suspended for a period 80 days a e afier work has commenced. <br /> I he applican[is res �ble for ing all quired inspections are <br /> requested in con rmAnce with e S ate Bui ding Code.This permit may be <br /> revoked an ti for d <br /> ! <br /> G / / <br /> � � <br /> ermitee Si na Date Issued y Si ture e <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED ABOV . <br />